Hepatitis B: Everything you wanted to know

Hepatitis is posing to be a major health problem in India. Based on the prevalence of the hepatitis B carrier state, it is divided into three zones:-

India falls in the intermediate endemic zone with the surface antigen prevalence between 2% and 10 % of populations.

Out of 25 million infants born every year, over one 1 million run the lifetime risk of developing chronic HBV infection.

What is Hepatitis?  - A dreadful liver disease

Hepatitis is a mix of different illnesses all causing an inflamed (swollen or painful) liver. If the liver does not work properly, then it can cause serious illness and sometimes death,

What is Hepatitis caused by? What are the Causative agents?

This disease is caused by the Hepatitis B virus. It exists in the serum in three particulate forms. Of the 3 particulate forms of HBV, the most numerous are the 22-nm particles, which appear as spherical or long filamentous forms.

How is Hepatitis transmitted?

Hepatitis B virus can be transmitted through

1. Parenteral and sexual route: - It is transmitted most often by a mucous membranes or percutaneous exposure to infective serum or visceral fluids. Saliva, serum, and semen have also been found to be infectious.
2. Percutaneous exposures include blood products transfusion; intravenous drug abusers, hemodialysis, and needle stick injuries in health care workers.
3. Vertical transmission of HBV is one of the major sources of transmission to neonates. The greatest risk of perinatal transmission of hepatitis occurs in infants of HBeAg-positive women.

Who is at risk of chronic disease?

The chance of an HBV infection to become chronic depends upon the age at which a person becomes infected.

In infants & children, chronic infections occur in

80–90% of infants infected during the first year

30–50% of children infected before the age of 6 years

In adults:

<5% of otherwise healthy persons who are infected as adults will develop chronic infection;

20–30% of adults who are chronically infected will develop cirrhosis and/or liver cancer.

What are the Symptoms of this disease?

Some people who are infected with the disease do not become very ill. Some do not become sick at all. Children are less likely to have symptoms than adults even when infected.

In more severe cases, hepatitis B can cause:

• Loss of appetite
• Nausea and vomiting
• Pain in the liver (under the right rib cage)
• Fever
• Pain in the joints
• Jaundice (when the eyes and skin become yellow).

Normally these symptoms disappear in a few weeks, but even when the person feels much better, he may still be infected with the virus and remain infectious.

What is the Diagnosis for hepatitis B?

It is first diagnosed with the blood test that checks for certain antigens. (fragments of HBV) and Antibodies ( Antibodies against the Surface antigen and core antigen)

Two types of anti-HBc antibodies are produced.

1. IgM
2. IgG

IgM antibodies are produced early in the course of infection. IgG antibodies are produced later in the course of infection and replace IgM antibodies.

Hepatitis B profile test:- It will help to detect the presence of Hepatitis B core, surface, envelope antigen. Also, antibodies produced against core, surface and envelope antigen.

1. HBsAg
2. Anti HBsAg Antibody
3. Anti HBcAg IgM
4. HBeAG
5. Anti HBeAG Antibody
6. Anti AHBC
7. Hepatitis Delta Virus total antibody

Get a Hepatitis B profile at www. phadkelabs.com. You will get the report within 4 days.

HBV Viral Load:-

This test measures the number of HBV in a blood sample. An HBV viral load greater than 20000 international units per millimeter (IU/Ml) of blood indicates that the virus is active and has the potential to cause damage to the liver. But experts believe even if the viral load is low treatment should be considered necessary since there is a risk of developing liver cancer.

What is the Treatment of Hepatitis B?

Chronic hepatitis B infections may be treated with antiviral medications such as pegylated interferon injections or oral antivirals.

How to prevent Hepatitis B?

Safe injection practices:-

1. The majority of the infection with HBV is acquired through unsafe percutaneous injection exposure. This can occur with the reuse of needles and syringes without proper sterilization. It can be prevented by using disposable syringes & needles.

2. In case of an injury, the affected area should be rinsed and washed thoroughly with soap and water

Safe blood transfusion:-

1. Screening of blood for infectious diseases so we can prevent other transfusion-transmitted diseases such as syphilis
2. The use of unpaid voluntary blood donors should be avoided. Proper screening of the blood should be done.

Safe sex practices:-

1. Unprotected sex is a common cause of HBV infection among young adults.
2. Sexual transmission of these hepatitis viruses can be prevented by avoiding sex with a person who has an ulcerative genital tract infection (e.g. a sexually-transmitted genital tract infection),
3. Use of barrier methods (condoms) during the sexual act
4. Screening of commercial sex workers for infection with HBV.

Prevention of Mother-to-child transmission:-

1. HBV is efficiently transmitted from pregnant mothers to their newborns if the mother has a high viral load.
2. This transmission may happen during the third trimester of gestation, during birth (passage of the baby through birth canal where it comes in contact with the maternal body secretions), or in the period after delivery (through close contact between mother and baby).
3. Focus is more on the prevention of this kind of transmission since HBV infection in infancy is much more likely to become chronic and hence lead to liver cirrhosis or liver cancer.
4. Mother-to-child HBV transmission can be interrupted through the administration of the hepatitis B vaccine to newborn babies, beginning with the first dose within 24 hours of birth. If a pregnant woman is known to have HBV infection and also has a positive HBeAg test or a high viral load, administration of specific hepatitis B immunoglobulin (HBIG) to the baby at birth and/or of oral anti-viral drugs to the mother in the third trimester of pregnancy may provide some additional protection.

Vaccines and immunoglobulins

Active and passive immunoprophylaxis (using specific vaccine and immunoglobulin, respectively) are available for preventing HBV infections.

We hope to have covered everything about this disease. In case you have any other questions or would like to book an appointment for a blood test go to phadkelabs.com or leave your comments below.